Anthropometry and plasma valine, amino acids, and proteins in the nutritional assessment of hemodialysis patients.
Non-fasting plasma amino acids, proteins, anthropometric measurements, urea, and creatinine for 17 hemodialysis patients were compared with values in normal patients of similar age and sex. Values were characteristic for renal failure but with similarities to protein-energy malnutrition. Partial correlation coefficients, correcting for age and height, identified nutritional and non-nutritional factors. Plasma valine was the most correlated variable and was used to rank and group the patients. The group with valine less than 150 micrometers/liter had low values for 17 variables. Valine, isoleucine, leucine, threonine, asparagine, weight, and arm muscle circumference were interrelated and reflected malnutrition whereas fat correlated with calorie intake, and histidine and serine with protein intake. Taurine, aspartic acid, cystine, citrulline, urea, creatinine, prealbumin and retinol-binding protein were decreased in malnutrition but were higher than normal due to a loss of renal function. Fourteen variables, less affected by malnutrition, were changed by specific non-nutritional factors. Hemodialysis patients of long standing (1 to 11 years) apart from two patients with recurrent sepsis, were adequately nourished, but those on hemodialysis for less than 15 months, most of whom had previously received peritoneal dialysis, were malnourished. Malnutrition in dialysis patients was due to protein and energy deficiency enhanced by metabolic abnormalities of amino acids. Our study shows that plasma valine is interrelated with other nutritional variables and may be used to assess protein-energy malnutrition.
D000293:Adolescent; D000328:Adult; D000596:Amino Acids / Q000097:blood*; D000886:Anthropometry; D001798:Blood Proteins / Q000032:analysis*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000178:diet therapy / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011502:Protein-Energy Malnutrition / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D014633:Valine / Q000097:blood
D000596:Amino Acids; D001798:Blood Proteins; D014633:Valine